Pariyaprasert Wipada, Pacharn Punchama, Visitsunthorn Nualanong, Chokephaibulkit Kulkanya, Sanpakit Kleebsabai, Viprakasit Vip, Vichyanond Pakit, Jirapongsananuruk Orathai
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand.
Asian Pac J Allergy Immunol. 2008 Mar;26(1):71-5.
Severe combined immunodeficiencies (SCID) are disorders with impairment of humoral and cellular immune functions. The prognosis of disseminated bacillus Calmette-Guérin (BCG) infection in immunocompromised host is unfavorable since response to standard therapy is poor. We report a successful treatment of disseminated BCG infection with granulocyte colony stimulating factor (G-CSF) in a patient with severe combined immunodeficiency. The patient failed to response to intensive anti-tuberculous (anti-TB) therapy. After 2 months of G-CSF, in addition to anti-TB treatment, the clinical signs of disseminated BCG infection were improved. Since serious BCG infections in SCID are not uncommon in developing countries, where BCG vaccination is mandatory to all newborns, the combination of G-CSF and anti-TB drugs should be considered in immunocompromised patients with protracted mycobacterial infection.
重症联合免疫缺陷(SCID)是体液免疫和细胞免疫功能受损的疾病。免疫功能低下宿主中播散性卡介苗(BCG)感染的预后不佳,因为对标准治疗的反应较差。我们报告了1例重症联合免疫缺陷患者采用粒细胞集落刺激因子(G-CSF)成功治疗播散性BCG感染的病例。该患者对强化抗结核治疗无反应。G-CSF治疗2个月后,除抗结核治疗外,播散性BCG感染的临床症状有所改善。由于在发展中国家,BCG接种对所有新生儿均为强制性,因此SCID患者发生严重BCG感染并不罕见,对于患有迁延性分枝杆菌感染的免疫功能低下患者,应考虑G-CSF与抗结核药物联合使用。